Is Sleep Debt Real? What to Know About Sleep Deprivation  

What Does It Mean to Have Sleep Debt?  

Sleep debt, also known as sleep deficit, is the difference between how much sleep you need and how much you actually get. When you sleep fewer hours than your body needs, you have a sleep debt. This “debt” adds up over time and can negatively impact your health.  

Sleep Debt vs. Sleep Deprivation  

Sleep deprivation occurs when the body gets less sleep than it needs. Even though seven hours of sleep per night is recommended for most adults, about 30 percent of U.S. adults get fewer than six hours, according to the Sleep Foundation.   

Sleep debt occurs when an individual experiences the cumulative effects of repeated sleep deprivation for several days or weeks. Another term for sleep debt is “insufficient sleep syndrome” because the insufficient level of sleep lasts for a longer period of time.  

What Are the Effects of Sleep Debt?  

Sleep is essential for good health. Not getting enough sleep over a period of time is linked to health problems, including obesity, diabetes, and heart disease. The mental benefits of sleep are also important. Sleep problems can make daily life feel more stressful and less productive and are also tied to depression. Research has shown that people who have trouble getting enough sleep can also have difficulties with tasks that require memory and learning.  

It’s easy to get stuck in a cycle of not getting enough sleep. Jonathan McFarland, DO, is a pulmonary medicine specialist who is board-certified in sleep medicine and director of the Sleep Center at Fort Sanders Regional Medical Center. He says the effects of sleep deficiencies can vary from person to person.  

How Many Hours of Sleep Do You Need?   

Healthline has provided the following age guidelines for healthy sleep from birth to adulthood:

• Birth to 3 months: 14-17 hours
• 4 to 11 months: 12-16 hours
• 1 to 2 years: 11-14 hours
• 3 to 5 years – 10-13 hours
• 6 to 12 years: 9-12 hours
• 13 to 18 years: 8-10 hours
• 18 to 64 years: 7-9 hours
• 65 years and older: 7-8 hours

“Adults fall somewhere on a spectrum of how much sleep they need per night,” says Dr. McFarland. “While most adults need the average 7-8 hours per night, there are variations. Some adults only need 5-6 hours to feel rested, and some need 9-10 hours, and they may worry there is something wrong with them.” 

What Are Sleep Cycles? 

We all naturally progress through several cycles during a night’s rest, says Dr. McFarland. The Sleep Foundation describes four stages of sleep. Each time a person completes all four stages, that’s one cycle. 

Stage 1 sleep is the time it takes for an individual to fall asleep, usually lasting 1-7 minutes. There are light changes in brain activity and the body begins to relax. You can easily wake in this stage but if you remain undisturbed, you move into Stage 2. 

During Stage 2, the muscles relax, the heart rate and breathing slow down and the body temperature drops. Brain waves show a new activity pattern during this stage, which lasts anywhere from 10-25 minutes. About half of our sleep time is spent in stage 2. 

Deep sleep, or slow wave sleep, is stage 3. The body relaxes even further in this stage, and it’s harder to wake someone who is in deep sleep. Experts believe this stage is critical to restorative sleep, which allows bodily recovery and growth. During the first part of the night, you spend approximately 20-40 minutes in stage 3. As the night progresses, this stage gets shorter.  

Stage 4 is REM sleep, or the “rapid eye movement” stage. Even though the eyes are closed, they can be seen moving quickly, which is how this stage gets its name. During REM sleep, brain activity picks up. This stage is essential for cognitive functions like memory. REM sleep is also when we have the most vivid dreams. While dreams can occur in any stage, they are less common and intense in stages 1-3. 

As the night goes on, REM stages lengthen, especially in the second half of the night. The first REM stage may last only a few minutes, but later stages can last for around an hour. In total, REM stages make up around 25 percent of sleep for adults.  

Deep Sleep and REM Sleep: How Much Is Enough?  

When people say ‘deep sleep’ they are usually referring to stages 3 and 4, or deep sleep and REM sleep. If people are constantly sleep deprived, there is a good chance they are not getting enough stage 3 or REM sleep. Most people, if they sleep 7-8 hours per night, are experiencing 3-5 sleep cycles. Time spent in each cycle depends on several factors, including age and phase of life. 

How to Avoid Sleep Debt  

The best way to avoid sleep debt is to develop healthy habits that support restful sleep. If you frequently don’t feel rested or are chronically sleep deprived, Dr. McFarland says it’s helpful to analyze your daytime behavior and your nighttime routine. There could also be underlying conditions that contribute to not sleeping, such as sleep apnea, depression, substance use, stress, lack of physical activity, or chronic pain, to name a few.   

Dr. McFarland says a sleep schedule and routine are important, especially in a household with both adults and children. “We can all benefit from ‘cues’ that it’s bedtime, whether it’s a stretching routine, a bath, or putting on pajamas. Anything you can do to relax and unwind helps signal your body that it’s time to get sleepy.” 

He adds, “I recommend removing electronics from the bedroom and not sleeping with the TV on or using your phone as an alarm clock. If this can’t be avoided, try deactivating the blue-light feature so it’s not as disruptive.” 

Health Habits That Affect Sleep

Dr. McFarland notes that getting enough exercise during the day can improve sleep. “The American Heart Association recommends 150 minutes of activity per week that gets your heart rate up, such as 30-minute sessions of vigorous walking or bike riding. Limiting stimulants such as caffeine, medications or other drugs after 2 p.m. also is a good practice, as these can keep us awake without our realizing the cause.” 

Dr. McFarland says that people may try to self-medicate to improve sleep, but their efforts usually make sleep quality worse. “Chronic use of opioids makes it harder to breathe during sleep,” he says, “and using sleeping pills regularly over time can prevent a person from getting deep sleep. Alcohol is also a major sleep disruptor.”  

He explains that “high blood pressure, asthma, or other health issues can affect sleep and even be worsened by sleep apnea. In some cases, this is reversible. If sleep apnea is related to obesity, losing weight can alleviate some issues like trouble breathing during sleep and high blood pressure.” 

Can You “Catch Up” or Recover from Sleep Debt?  

Although a nap might help you feel temporarily refreshed, Dr. McFarland says, “There is no such thing as ‘repaying your debt’ when you don’t get enough sleep. You can’t get only a few hours’ sleep per night and think ‘I’ll catch up on sleep this weekend.’ It doesn’t work like that.” 

How Long Does Sleep Debt Last?   

The effects of sleep debt are highly individualized. But according to Medical News Today, in a studied group of individuals who experienced sleep deprivation for 10 days followed by one week of regular sleep, most measures of cognitive performance had not yet returned to normal. The study found that “catch-up sleep” is not an efficient way to counteract sleep debt. 

When to Seek Help for Sleep Disorders 

 Help is available from Covenant Health’s Sleep Centers. At several convenient locations you can consult with a specialist, who can help identify issues that are affecting your sleep and develop a customized and effective treatment plan.   

What is a Sleep Study? 

A sleep study helps medical specialists gather data related to an individual’s sleep patterns, with the goal of helping a person get better quality, more restful sleep.  

“Our goal is to help find the core issue of why you can’t fall asleep or stay asleep,” says Dr. McFarland. “Most of the issues we see have to do with obstructive sleep apnea. Many men come in at the insistence of their wives, who complain about their husbands’ snoring,” he says with a laugh. “If you are waking up gasping for air, or your partner tells you that you go periods of time during sleep without breathing, there may be something going on with your airway.” 

The most common treatment for sleep apnea is a CPAP machine, a device that delivers mild levels of continuous positive airway pressure to help keep the throat open for adequate breathing during sleep.  

“For some people it drastically changes their life. It improves their daytime function, performance and social life,” Dr. McFarland says. There are also other options for treating sleep apnea. “Oral devices prescribed by a dentist can be worn at night to help bring the jaw and tongue forward if the airway is the issue. There are sleeping positions to use and to avoid. For example, sleeping on your back is the least beneficial if you have sleep apnea.”   

Other health concerns can prevent quality sleep. A sleep study patient might be referred to a primary care provider or to a psychologist for cognitive behavioral therapy. “If a patient has an autoimmune disorder, injury, joint pain or other chronic pain, a sleep study can help identify factors that affect sleep. We can prescribe medications for things like restless leg syndrome, or recommend a physical therapist,” Dr. McFarland says. 

For Additional Help 

Ready to say “good-night” to sleep deprivation and sleep debt? You can self-refer to a Covenant Health Sleep Center. Visit our web page for details and locations. For more about better sleep, check out these helpful articles:  

• 5 Tips For Better Sleep 
• Sleep Success For Older Adults 
• How Much Sleep Do Kids Need?